title: Breast cancer in women aged 25 years and younger.
abstract: OBJECTIVE
  To evaluate breast cancer characteristics in women aged 25 years and younger.
  
  
  METHODS
  This was a retrospective, nested, within-cases matched study. The study design was based on a two-phase protocol. In the first phase, stage, grade, histologic subtype, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status were compared between 28 patients (aged 25 years and younger) and 685 older premenopausal women (aged older than 25 years) with breast cancer. The second phase aimed to determine whether young patients exhibited worse prognosis when compared with older premenopausal women.
  
  
  RESULTS
  Young patients presented at a more advanced stage (P=.012) and exhibited a higher grade (P=.018). No significant differences were noted regarding histologic subtype, estrogen receptor, and progesterone receptor status. Genetic testing for BRCA1 and BRCA2 mutations was performed in 12 of 28 young patients and mutations were found in 25% of them. Moreover, young women presented poorer overall survival (hazard ratio [HR] 4.30, 95% confidence interval [CI] 1.09-17.03) than their older counterparts, matched by histologic subtype, stage, and grade; a similar pattern was noted regarding relapse-free survival (HR 8.28, 95% CI 2.24-30.60).
  
  
  CONCLUSIONS
  Breast cancer diagnosis in women aged 25 years and younger is uncommon; however, these patients present at a more advanced stage, with a higher grade, and exhibit poorer survival.
authors.affiliation: Departments of Obstetrics and Gynecology and Clinical Therapeutics, Alexandra Hospital, Medical School, University of Athens, and the 1 Propaedeutic Surgical Department, Hippocrateio Hospital, Medical School, University of Athens, Athens, Greece.
authors.forename: Constantine
authors.initials: C
authors.lastname: Dimitrakakis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Tsigginou
authors.forename: Flora
authors.initials: F
authors.lastname: Zagouri
authors.forename: Spyros
authors.initials: S
authors.lastname: Marinopoulos
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Antonis
authors.initials: A
authors.lastname: Keramopoulos
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Liakou
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos
authors.forename: Christos A
authors.initials: CA
authors.lastname: Papadimitriou
authors.forename: Meletios-Athanassios
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D015999:Multivariate Analysis; D018299:Neoplasms, Ductal, Lobular, and Medullary / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult